Dental abutment screw extractor

ABSTRACT

Described herein are systems and methods for extracting a broken fragment of a dental abutment screw from a dental implant. One system includes an extractor tool having a tubular outer body and a conductor positioned within the tubular outer body, and an applicator that receives and end of the extractor tool and also includes a heating element that converts electrical energy into heat that is conducted to the extractor tool to melt a thermoplastic adhesive in a cavity at the distal end of the extractor tool, such that the melted thermoplastic adhesive can conform to and engage with a broken fragment of a dental abutment screw within a dental implant when the adhesive cools. The extractor tool can then be rotated to unscrew the broken fragment from the dental implant.

CROSS-REFERENCE TO RELATED APPLICATIONS

This is the U.S. National Stage of International Application No.PCT/US2015/044613, filed Aug. 11, 2015, which was published in Englishunder PCT Article 21(2), and which claims the benefit of U.S.Provisional Application No. 62/036,491 filed Aug. 12, 2014, which isincorporated by reference herein in its entirety.

FIELD

This application is related devices and methods for removing a brokendental abutment screw from a dental implant.

BACKGROUND

FIG. 1 shows an conventional dental prosthesis for replacing a naturaltooth. The dental prosthesis includes a dental implant that is implantedinto a patient's bone. A dental abutment and screw are mounted on thedental implant. The abutment screw is torqued to approximately 35 N-cm.A crown can then be mounted on the abutment screw. FIG. 2 shows anexemplary dental implant 2 with an exemplary abutment screw 4 mounted inthe implant. The screw 4 includes an abutment head 6, a neck 8, and athreaded portion 10 that is engaged with inner threads of the implant 2.Sometimes such an abutment screw can break at the neck 8 such that theabutment screw head 6 is removed but the threaded portion 10 and perhapssome of the neck remains stuck in the dental implant. This can happen,for example, due to excessive torque off axis or excessive forces on themouth. Removing a remnant of a broken abutment screw from within adental implant can be clinically challenging.

One removal technique is to drill a small hole within the brokenfragment with reverse-oriented threads, then insert a smaller screw ortool into the reverse threads to unscrew the broken screw fragment.Another approach is to create a groove in the broken screw fragment toassist is turning it with a tool similar to a screw driver. However,these approaches can be problematic because they can further damage thebroken screw fragment, can damage the internal dental implant threads,can cause the broken screw fragment to break up into smaller pieces,and/or can damage the surrounding dental implant. Another approachsometimes used is to manually attempt to turn the screw fragment with adental explorer, however this technique can be time consuming anddifficult to accomplish. Another approach is to use an ultrasonicinstrument to pulsate the screw fragment and encourage rotational force.

SUMMARY

Described herein are systems and methods for extracting a brokenfragment of a dental abutment screw from a dental implant.

An exemplary disclosed method for extracting a broken fragment of adental abutment screw from a dental implant comprises positioning anextraction tool in a patient's mouth such that a thermoplastic adhesivein a distal end portion of the extraction tool is adjacent to a brokenfragment of a dental abutment screw that is mounted within a dentalimplant in the patient's mouth; applying heat to the thermoplasticadhesive via the extraction tool to melt the thermoplastic adhesive suchthat the thermoplastic adhesive conforms to surfaces of the brokenfragment; allowing the thermoplastic adhesive to cool such that itsolidifies and bonds the extraction tool to the broken fragment; androtating the extraction tool to unscrew the broken fragment from thedental implant.

An exemplary disclosed system comprises an extractor tool having atubular outer body and a conductor positioned within the tubular outerbody. The extractor tool can have a bent “L” shape, a straight “I”shape, or other shapes. The system can also include an applicator devicethat provides heat to the extractor tool. In some embodiments, ahandheld applicator device includes a collet that receives and holds aproximal end of the extractor tool and also includes a heating elementthat converts electrical energy into heat that is conducted along theconductor to melt a thermoplastic adhesive in a cavity at the distal endof the extractor tool such that the melted thermoplastic adhesive canbond the extractor tool to a broken fragment of a dental abutment screwwithin a dental implant when the adhesive cools. In other embodiments, abench top applicator device includes a heating element that temporarilyreceives the distal end of the extractor tool and applies heat to thedistal end of the extractor tool, then the extractor tool is removedfrom the heating element and applied to a broken abutment screw. In suchembodiments, a proximal end of the extractor tool can include aninsulated gripping portion for a user to hold and manipulate theextractor tool. The extractor tool can then be rotated to unscrew thebroken fragment from the dental implant.

The foregoing and other objects, features, and advantages of thedisclosed technology will become more apparent from the followingdetailed description, which proceeds with reference to the accompanyingfigures.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a schematic diagram of an exemplary dental prosthesisimplanted in a patient, in comparison to a natural tooth.

FIG. 2 is a side view, partially in cross-section, of an exemplarydental implant and abutment screw of a dental prosthesis.

FIG. 3 shows an exemplary system for extracting a broken abutment screw.

FIG. 4 is a longitudinal cross-sectional view of an exemplary hand-heldapplicator of the system of FIG. 3.

FIG. 5 shows an exemplary extraction tool used with the system of FIG.3.

FIG. 6 shows an exemplary extraction tool used with the system of FIG.3.

FIG. 7 shows exemplary electrical circuits for the system of FIG. 3.

FIG. 8 shows exemplary electrical circuits for the system of FIG. 3.

FIG. 9 is a side cross-sectional view of the extraction tool of FIG. 5secured to a broken fragment of an abutment screw within a dentalimplant.

FIG. 10 is a side cross-sectional view of another exemplary extractiontool.

FIG. 11 is a side cross-sectional view of an exemplary bench topapplicator device for applying heat to the extraction tool of FIG. 10.

DETAILED DESCRIPTION

Described herein are systems, devices, and methods for removing a brokendental abutment screw from a dental implant using a thermoplasticadhesive to attach an extraction tool to the broken screw such that theextraction tool can be rotated to unscrew the broken screw from thedental implant.

FIG. 3 shows an exemplary system 20 for removing a broken dentalabutment screw using a screw-specific extraction tool, such as the tool60 illustrated in FIG. 5, along with a thermoplastic adhesive. FIG. 9shows the tool 60 of FIG. 5 having been secured to a broken neck portion8 of an abutment screw 4 with a thermoplastic adhesive 74 using thesystem of FIG. 3.

The system 20 shown in FIG. 3 includes an applicator 22, a controller24, and a plug 26, which are electrically coupled together via wires. Inalternative embodiments, the components of the controller 24 can becombined with the plug 26 to simplify the system 20.

The plug 26 attaches to a power source, such as a common AC poweroutlet, and is configured to convert electrical power from AC to DC at aspecified voltage for use by the controller 24 and applicator 22.

The controller 24 can include electrical circuitry that controls thepower supplied from the plug 26 to the applicator 22 for generatingheat. The controller 24 can include a time-controlled circuit, forexample, that applies a predetermined level of power to the applicator22 over a predetermined period of time after it is activated. Thepredetermined level of power and the predetermined period of time can beselected based on the type of thermoplastic adhesive that is used and/orother application-specific factors. The controller 24 can include alight or other indicator 34 that indicates when the plug 26 is coupledto a power source and the controller is available for supplying power tothe applicator 22. An exemplary electrical circuit diagram 80 for thecontroller 24 is shown in FIG. 7. The exemplary circuit 80 utilizes a555 timer that acts as a clock. The amount of time that passes is basedupon the capacitors and resistors placed in series. The 555 timer is inmonostable configuration, meaning that only one pulse is produced witheach triggered operation.

The applicator 22 is shown in longitudinal cross-section in FIG. 4. Theapplicator 22 includes a body or frame or housing 40 that is shaped tobe held by a user in one hand and has a distal end 42 having arelatively narrow dimension for inserting into a patient's mouth. Theapplicator 22 also includes a collet 44 located near the distal end 42that is configured to receive and retain a tool, such as the tool 60shown in FIG. 5, for engaging a broken dental abutment screw in apatient's mouth. A heating element, or filament, 46 is positionedadjacent to the collet 44 and is configured to be thermally coupled tothe tool when it is inserted into the collet. The heating element 46 maybe in direct contact with the tool or there can be an intermediateconductive material, such as a portion of the collet 44, therebetween.The heating element 46 converts electricity to heat that is conductedalong the extraction tool to a thermoplastic adhesive located at thedistal end of the tool in order to melt the adhesive and secure the toolto a broken abutment screw.

The heating element 46 is electrically coupled to the controller 24 andto a circuit 58 located within the applicator 22. An exemplary circuitdiagram 90 for the circuit 58 is shown in FIG. 8. In some embodiments,the circuit 58 can be combined with the circuitry in the controller 24to minimize the bulkiness of the applicator 22. At least one activator,button, or other control 30 is provided on the applicator 22 that theuser can press or otherwise interact with to cause circuit 58 and/or thecontroller 24 to begin supplying power to the heating element 46. Alight or other indicator 32 can also be provided on the applicator 22 toindicate when the heating element 46 is actively powered. Although notshown in FIG. 4, wiring can be included in the applicator 22 toelectrically coupled the heating element 46, the circuit 58, theactivator 30, and the light 32, and/or other electrical components inthe applicator, and to electrically couple the applicator to thecontroller 24.

As further shown in FIG. 4, the applicator 22 can include a mechanismfor inserting, securing, and releasing a selected extraction tool. FIG.4 shows one exemplary mechanism wherein a shaft 48 extendslongitudinally through the applicator 22 with a distal end of the shaftcoupled to the collet 44 and a proximal end of the shaft coupled to aplunger 50 that extends from the proximal end of the body 40. A spring52 can be positioned around or alongside the shaft 48 to bias the shaft,plunger 50, and collet 44 toward a proximal position that is shown inFIG. 4. A distal end of the spring 52 can abut a wall 56 that is fixedrelative to the body 40 and a proximal end of the spring can abut awasher 54 that is fixed relative to the shaft 48. As the user pressesthe plunger 50 distally into the body 40, the shaft and washer 54 movedistally and compress the spring 52 between the washer 54 and the wall56. The distal motion of the shaft 48 also causes the collet 44 to movedistally such that the collet moves partially out of the distal end 42of the body. This allows the collet 44 to radially expand such that thecollet can receive a proximal end of a selected extraction tool, such asthe proximal end 66 of the tool 60 shown in FIG. 5. Once the tool isinserted into the collet 44, the plunger 50 can be released by the user,such that the compressed spring 52 pushes the washer 54 and shaft 48back proximally toward the proximal position shown in FIG. 4. Thisproximal motion of the shaft 48 pulls the collet 44 and inserted toolinto the distal end 42 of the body, wherein the collet becomes radiallycompressed and grips the tool securely. When the collet is retractedinto the body 40, the distal end of the tool and/or the collet 44 can bein contact with the heating element 46 such that heat can be conductedfrom the heating element, through the tool to the thermoplastic adhesiveat the distal end of the tool.

In other embodiments, the applicator 22 can include other mechanisms forinserting, securing, and/or releasing a selected extraction tool. Forexample, the applicator 22 can include a push mechanism at the distalend 42 of the body that can be pushed by a user to release or detach atool. Another alternative is to use a more ergonomic lever and springmechanism. By pressing on the lever, the spring is compressed to exposethe collet.

FIG. 5 is a cross-sectional view of an exemplary extraction tool 60 thatcan be secured to a broken dental abutment screw (as shown in FIG. 9)and torqued to unscrew the broken dental abutment screw from a dentalimplant. The tool 60 comprises a tubular body 62 and an inner conductor64 that are bent at an elbow 72 or otherwise formed in a non-straightshape, such as at a substantially perpendicular shape. The body 62 isshown in more detail in FIG. 6. The tool 60 has a proximal end 66 thatis configured to be inserted into and secured by the collet 44 of theapplicator 22, and has a distal end 68 that is configured to be securedto a broken dental abutment screw. The conductor 64 is positioned withthe body 62 and extends from the proximal end 66 of the tool to alocation short of the distal end 68 of the tool, forming a cavity 70within the distal end of the body 62. The cavity 70 can be loaded with athermoplastic adhesive in a solid state. The dimensions “h” and “d” ofthe cavity 70 (see FIG. 6) can be selected based on the size and shapeof the broken dental abutment screw and the dental implant, theparticular type of thermoplastic adhesive being used, and/or otherfactors. Similarly, the dimensions “L” and “D” of the body 62 can beselected based on the size and shape of the broken dental abutment screwand the dental implant, the position of the dental implant in thepatient's mouth, the size and shape of the patient's mouth, the size andshape of the applicator and the collet, and/or other factors.

In some embodiments, the distal end of the body 62 of the tool can betapered or the tool can further include a tapered annular body that fitsaround the distal end of body 62. Such a tapered outer surface at thedistal end of the tool can also the tool to conform to certain dentalimplants that include a tapered opening into which the abutment screw isinserted. In some embodiments, the tapered outer surface of the tool canmore fully fill the abutment screw opening in the dental implant whenthe tool is in contact with the broken screw fragment inside theimplant. This can ensure an accurate alignment of the tool with thebroken screw, and can reduce movement of the tool relative to the screwfragment while the thermoplastic adhesive solidifies to provide astronger bond.

The body 62 can comprise any sufficiently rigid material and has arelatively low thermal conductivity relative to the conductor 64 (e.g.,stainless steel or titanium), such that the body 62 can act to transmitsufficient torque for unscrewing the broken screw and can act as aninsulator around the conductor as heat flows from through the conductorto the adhesive. The conductor 64 can comprise copper or other materialhaving a high thermal conductivity.

The thermoplastic adhesive can be selected such that is providessufficient adhesive strength when bonding to the broken abutment screw(e.g., titanium alloy) and the tool (e.g., stainless steel, copper,etc.). Desirable adhesives feature a low melting point (e.g., under 100°C.) and nontoxic substrates. Exemplary thermoplastic adhesives includeethylene-vinyl acetate and ethylene-acrylate. Dental sticky wax can alsobe used as the adhesive. Dental sticky wax can include various materialsthat typically include natural beeswax or synthetic beeswax and a resin.Exemplary sticky waxes include Trubyte® Waxes available from Dentsplyand fall under Federal Specification number U-W-00149a. Thethermoplastic adhesive can have a melting temperature that issufficiently above room temperature so that it remains solid until heatis applied during use, but not too high so that it is safe for usewithin a patient's mouth and so that it can be melted quickly withouttoo much heat needing to be applied from the system 20. For example, themelting temperature of the thermoplastic adhesive can be between about50° C. and about 100° C., such as about 80° C.

Prior to use, the thermoplastic adhesive can be placed in the cavity 70at the distal end of the tool 60 such that the thermoplastic adhesive isin contact with the conductor 64 and completely or partially fills thecavity 70.

The system 20 can be used with a variety of differently configured toolsto remove different types and sizes of screws from different toothlocations and different sized mouths. The system 20 can be provided witha set of differently configured tools to choose from to extract a givebroken dental abutment screw. For example, the user can match the innerdiameter “d” and depth “h” of the cavity 70 (FIG. 6) to the diameter andheight of the broken neck 8 (see FIG. 2) of the dental abutment screw 4to the inner diameter. The user can also match the length “L” of thetool 60 to fit the tool comfortably within the patient's mouth.

The selected tool 60 with a thermoplastic adhesive 74 loaded in thecavity 70 can then be loaded into the collet 44 of the applicator 22 andthe plug 26 can be connected to a power source to provide power. Asillustrated in FIG. 9, the distal end 68 of the tool 60 can then beplaced into the dental implant 2 such that the thermoplastic adhesive 74contacts the top of the screw fragment within the dental implant. Theouter diameter at the distal end 68 of the tool 60 can be sized smallenough to fit into the opening of the dental implant 2 to access thebroken fragment of the abutment screw 4.

The user can then press the activator 30 on the applicator 22 to beingheat application from the heating element 46 through the conductor 64 tothe thermoplastic adhesive 74 while holding the thermoplastic adhesiveagainst the top of the broken screw 4. As the thermoplastic adhesive 74melts, it can conform around the exposed upper end of the broken screw 4(e.g., the neck portion 8) and the distal end 68 of the body 62 canlower around the sides of the upper end of the broken screw, asillustrated in FIG. 9. A dental abutment screw typically fractures atthe narrow neck region 8, which is narrower than the surrounding innerwalls of the implant 2, leaving an annular gap between the fracturedneck 8 and the inner walls of the implant 2. The distal end 68 of thebody 62 can move down into this annular gap, as shown in FIG. 9, as thethermoplastic adhesive 74 melts and the broken neck 8 moves into thecavity 70.

The melting process can take about two minutes, in one embodiment, andcan take longer or shorter times in other embodiments. The circuit 80 inthe controller 24 can be set to supply power to the heating element fora predetermined time, such as two minutes, then turn the heating elementoff. When the melting process is complete, the light 32 can turn off tosignal the user.

Once the heating element 44 is turned off and the thermoplastic adhesive74 is melted, the applicator 22 and tool 60 can continue to be heldstationary relative to the screw fragment 4 while the thermoplasticadhesive 74 solidifies and bonds to the screw fragment and the tool. Thesmall diameter of the distal end of the extraction tool minimizes therisk of interference with the dental implant. The cooling process canoptionally be assisted by applying cool air flow over the tool 60. Thiscan be perform, for example, by using conventional dental air tool toblow air over the tool 60. This can take about 15 seconds, in oneexample. Other fluids, such as other gasses or water, can also be usedto cool the tool. Cooling the tool cause heat to be conducted away fromthe thermoplastic adhesive 74 through the tool 60.

Once the tool 60 is adhered to the broken screw via the solidifiedthermoplastic adhesive 74 (as shown in FIG. 9), the tool can be ejectedor disengaged from the collet 44 of the applicator 22 by depressing theplunger 50. The tool 60 can then be manually rotated, similar to anAllen wrench, to unscrew the broken screw 4 from the dental implant 2.The elbow 72 in the tool 60 can help the user apply a sufficient torqueusing the proximal end 66 as a lever arm to rotate the tool.

In other embodiments, the disclosed extraction tool 60 can be used withother heat sources to supply the needed heat to melt the adhesive. Inother embodiments, the extraction tool 60 can include a heating element,such as within the body 62 and contacting the conductor 64, which can beelectrically coupled to an external power source.

In some embodiment, a bench top applicator can be used to supply heat toan extractor tool, and then the heated extractor tool can bedisconnected from the applicator and manually applied to a brokenabutment screw in the mouth. For example, FIGS. 10 and 11 illustrate anextractor tool 100 and a bench top applicator device 120. The extractortool 100 can have be straight (as shown in FIG. 10) or have a bent “L”shape or other bent shape. The tool 100 includes a tubular body 102(e.g., stainless steel) with another material, such as a conductor metal(e.g., copper) 104 inside the tubular body 102. The conductor 104 canstop short of a distal end 110 of the tubular body 102 to provide acavity 106 for the thermoplastic adhesive. The proximal end 112 of theextractor 100 can include a grip 108 that acts as an insulator for auser to hold and manipulate the extractor. For example, the grip 108 cancomprise silicone or other insulating material that also provides enoughgrip to allow the user to apply forces to the extractor. The grip 108can extend over and cover the proximal end of the body 102 and conductor104 for safety and to minimize heat loss through the proximal end.

The applicator 120 shown in FIG. 11 includes a rigid body 122,electrical circuitry 124 inside the body, a power supply cord 126 orother power source, an electrical heating element 128 with a centralrecess 130, an activator 132, and optionally indicators 134 and 136. Theapplicator 120 is configured to remain stationary while the extractor100 is applied to the applicator for heating and then removed from theapplicator to manually introduce the extractor into the mouth. Thedistal end 110 of the extractor 100 is inserted into the recess 130 inthe heating element 128 and the activator is used to start the heatingprocess. Electrical power is converted to heat by the heating element128, and the heat is conducted into the extractor 100. The distal end110 of the extractor can be inserted to a depth sufficient to heat theadhesive in the pocket 106 and heat the conductor 104. The indicator 134can illuminate when the power cord 126 is plugged in and the device haspower, and the indicator 136 can illuminate when the activator 132 isactivated until a predetermined time has elapsed, after which theindicator turns off to indicate to the user that the heating process iscomplete and the extractor 100 can be removed from the heating element128 and applied to a broken abutment screw. Circuitry similar to thatshown in FIGS. 6 and 7 can be included in the circuitry 124 of theapplicator 120.

After the extractor 100 is heated and removed from the applicator 120,the user can hold the extractor by the insulated grip 108 and apply thecavity 106 over a broken abutment screw. The conductor 104 retain heatand can help maintain the thermoplastic adhesive at a sufficiently hightemperature during the transfer until it is engaged with the brokenscrew. The user can hold the extractor 100 with sufficient pressure onthe broken screw until the thermoplastic adhesive cools and sets aroundthe broken screw to create a sufficiently strong bond or fit with thebroken screw. The user can then rotate the extractor 100 by twisting thegrip 108 with his fingers or with another tool, such as forceps or thelike, to remove the broken screw.

The technology disclosed herein with regard to removing a broken dentalabutment screw can also be used for removing other types of brokenscrews, such as other types of dental screws or similar screws used inother parts of the body.

Any of the features or technologies described herein in relation to anyone or more of the described embodiments can also be used with orincluded in any of the other described embodiments where possible, evenif such features or technologies are not specifically mentioned indirect connection to a specific embodiment.

The singular terms “a”, “an”, and “the” include plural referents unlesscontext clearly indicates otherwise. The term “comprises” means“includes without limitation.” The term “coupled” means physicallylinked and does not exclude intermediate elements between the coupledelements. The term “and/or” means any one or more of the elementslisted. Thus, the term “A and/or B” means “A”, “B” or “A and B.”

Although methods and materials similar or equivalent to those describedherein can be used in the practice or testing of the present technology,only certain suitable methods and materials are described herein. Incase of conflict, the present specification, including terms, willcontrol. In addition, the materials, methods, and devices areillustrative only and not intended to be limiting.

In view of the many possible embodiments to which the principles of thedisclosed technology may be applied, it should be recognized that theillustrated embodiments are only examples and should not be taken aslimiting the scope of the disclosure. Rather, the scope of thedisclosure is at least as broad as the following claims. We thereforeclaim as our invention all that comes within the scope of the followingclaims.

The invention claimed is:
 1. A method for extracting a broken fragment of a dental abutment screw from a dental implant in a patient's mouth, the method comprising: mounting a proximal end of an extraction tool in a hand-held applicator, prior to positioning the extraction tool in the patient's mouth, wherein mounting a proximal end of the extraction tool in the hand-held applicator comprises: opening a collet of the hand-held applicator; inserting the proximal end of the extraction tool into the collet; and closing the collet to secure the extraction tool to the hand-held applicator; applying heat to a thermoplastic adhesive in a distal end portion of the extraction tool via the hand-held applicator to melt the thermoplastic adhesive; positioning the extraction tool in the patient's mouth such that the thermoplastic adhesive in the distal end portion of the extraction tool contacts the broken fragment of the dental abutment screw that is mounted within the dental implant in the patient's mouth; wherein the application of heat to the thermoplastic adhesive occurs before or after the extraction tool is positioned in the patient's mouth; allowing the melted thermoplastic adhesive to conform to surfaces of the broken fragment; allowing the thermoplastic adhesive to cool such that it solidifies around the broken fragment; and rotating the extraction tool to unscrew the broken fragment from the dental implant; detaching the extraction tool from the hand-held applicator after applying heat to the thermoplastic adhesive and prior to rotating the extraction tool.
 2. The method of claim 1, wherein applying the heat to the thermoplastic adhesive comprises supplying power to a heating element in the hand-held applicator while it is coupled to the proximal end of the extraction tool.
 3. The method of claim 2, wherein supplying the power to the heating element in the hand-held applicator comprises pressing a button on the hand-held applicator to provide a predetermined level of electrical power to the heating element for a predetermined period of time.
 4. The method of claim 1, wherein allowing the thermoplastic adhesive to cool comprises blowing air on the extraction tool to cause conduction of heat from the thermoplastic adhesive into the extraction tool.
 5. The method of claim 1, wherein opening the collet comprises depressing a plunger at a proximal end of the hand-held applicator and closing the collet comprises releasing the plunger.
 6. The method of claim 1, further comprising urging the distal end portion of the extraction tool toward the broken fragment while the thermoplastic adhesive is at least partially melted to cause a portion of the broken fragment to move into a cavity in the distal end portion of the extraction tool.
 7. A method for extracting a broken fragment of a dental abutment screw from a dental implant in a patient's mouth, the method comprising: positioning an extraction tool in the patient's mouth such that a thermoplastic adhesive in a distal end portion of the extraction tool contacts the broken fragment of the dental abutment screw that is mounted within the dental implant in the patient's mouth; applying heat to the thermoplastic adhesive to melt the thermoplastic adhesive via a hand-held applicator, wherein the application of heat to the thermoplastic adhesive occurs before or after the extraction tool is positioned in the patient's mouth; allowing the melted thermoplastic adhesive to conform to surfaces of the broken fragment; allowing the thermoplastic adhesive to cool such that the thermoplastic adhesive solidifies around the broken fragment; rotating the extraction tool to unscrew the broken fragment from the dental implant; wherein the method further comprises: mounting a proximal end of the extraction tool in the hand-held applicator, prior to positioning the extraction tool in the patient's mouth, and applying the heat to the thermoplastic adhesive via the hand-held applicator to melt the thermoplastic adhesive; and wherein mounting the proximal end of the extraction tool in the hand-held applicator comprises: opening a collet of the hand-held applicator, inserting the proximal end of the extraction tool into the collet, and closing the collet to secure the extraction tool to the hand-held applicator.
 8. The method of claim 7, wherein applying the heat to the thermoplastic adhesive comprises supplying power to a heating element in the hand-held applicator while it is coupled to the proximal end of the extraction tool.
 9. The method of claim 8, wherein supplying the power to the heating element in the hand-held applicator comprises pressing a button on the hand-held applicator to provide a predetermined level of electrical power to the heating element for a predetermined period of time.
 10. The method of claim 7, wherein allowing the thermoplastic adhesive to cool comprises blowing air on the extraction tool to cause conduction of heat from the thermoplastic adhesive into the extraction tool.
 11. The method of claim 7, wherein opening the collet comprises depressing a plunger at a proximal end of the hand-held applicator and closing the collet comprises releasing the plunger.
 12. The method of claim 7, further comprising urging the distal end portion of the extraction tool toward the broken fragment while the thermoplastic adhesive is at least partially melted to cause a portion of the broken fragment to move into a cavity in the distal end portion of the extraction tool. 